1. Field of the Invention
The present invention relates to exercise and rehabilitation devices, and more particularly to a telescopically adjustable exercise device that pivotably removably receives one or more exercise attachments for the manual exercise of an individual's upper extremities.
2. Description of the Prior Art
An injury to an individual's upper extremity, which may include the individual's shoulder, arm, elbow, wrist and/or the supportive tissue between the joints, typically requires some form of rehabilitation. Such rehabilitation generally involves the reestablishment of several physical aspects of the involved upper extremity. For example, depending on the particular injury sustained, an individual's range of motion is often significantly reduced after an upper extremity injury. Varying magnitudes of neuromotor inhibition and muscle atrophy are also experienced as a result of such injuries. Accordingly, the appropriate level of kinetic neuromotor control must be reestablished. The patient may also experience a measured loss in kinesthetic awareness, which must be reestablished in order to minimize the level of altered limb coordination and reaction time experienced by the patient. It is also important to reestablish the patient's functional activity so that they are able to return to a desired pre-morbid activity level without an unreasonable risk of re-injury or further degeneration. Ultimately, the patient is rehabilitated through the stages of healing beginning with the inflammatory stage, progressing through the proliferation stage, and completing the rehabilitation with the remodeling stage.
When reestablishing a patient's range of motion, it is important to initially limit the patient's muscle activity in the injured upper extremity. The introduction of passive range of motion at this stage of rehabilitation limits the risk of re-injury or irritation to the upper extremity. This is typically achieved through the passive movement of the injured arm by an external force such as an automated machine, a physical therapist, or the patient's unaffected arm. Those methods that allow the patient to self-articulate the injured upper extremity allow for a greater flexibility in the patient's rehabilitation program. Without the requirement of expensive machinery or a physical therapist, the patient is able to work on the exercises in the comfort of the patient's home at a time convenient for the patient.
One prior art method for allowing the patient to self-articulate the injured upper extremity typically involves the use of a broom handle. Using this method, the patient grasps opposite ends of the broom handle with both hands. The patient then uses his healthy arm and shoulder to move the broom handle reciprocally in vertical, horizontal or diagonal directions. These motions cause the patient's injured arm to move responsively through the upper extremities' available range of motion. This prior art method suffers from two serious problems. First, the rigid nature of the broom handle tends to force the injured arm in particular directions, irrespective of the natural range of motion provided by the joints and accompanying soft tissue. Forcing the injured upper extremity to travel in unnatural or undesired ranges of motion typically causes the patient to re-injure the upper extremity rather than rehabilitate it. Aside from its inability to mimic normal biomechanics, the broom handle method is also problematic in that it requires the active use of the muscles of the injured upper extremity to grip the broom handle, which works against the definition of passive range of motion.
An example of a prior art device that was developed in an effort to address the problems encountered when a patient uses an exercise device such as a broom handle is disclosed in U.S. Pat. No. 4,395,039. The device itself is comprised of an elongated bar having opposite ends. One end is adapted to be gripped by the patient's healthy arm. The opposite end of the bar is attached to one end of an elastic cord that has a gripping handle disposed at the opposite end. In use, the patient grips the gripping handle with his injured arm. The patient then uses his healthy arm to articulate the exercise bar in a manner similar to that using the broom handle. The device improves upon the broom handle method by providing some passive range of motion that is not as rigidly dictated by the exercise bar as a patient will experience with the broom handle. However, this device can achieve a range of motion in the injured upper extremity that is too independent of the movement of the exercise bar. Due to the flexible nature of the elastic cord, the device lacks an element of precision when directing the injured upper extremity through a desired range of motion. Moreover, this device, much like the broom handle, must be actively gripped by the patient's injured arm. Again, this is inconsistent with the goals of passive range of motion exercises.
The next stage of the rehabilitation process is the reestablishment of kinetic neuromotor control at specific sequences throughout the injured upper extremities' range of motion. This goal can be attained through graded isotonic muscle activity of synergistic-specific muscles or muscle groups within the injured upper extremity while providing a measured level of graded force from the healthy upper extremity. None of the prior art exercise devices can provide this necessary element while simultaneously allowing multi-plane joint-independent range of motion without the necessity of active motor work at the distal end of the injured upper extremity.
In the next stage of rehabilitation, the patient engages in restrictive range of motion exercises to regain the strength necessary to achieve an active range of motion in the injured extremity, independent of any external assistance. In order to safely transition a patient to functional active ranges of motion independent of assistance, it is preferred that the exercise device used by the patient support both open kinetic chain and closed kinetic chain exercises. Moreover, an exercise tool used in this stage of rehabilitation should support agonist, antagonist, isometric and isotonic muscle activity through graded forces applied through both the injured and healthy upper extremities. None of the prior art exercise devices are capable of such a flexible utility. Accordingly, multiple exercise tools must be used in an attempt to safely attain an active range of motion.
Accordingly, what is needed is a single exercise device that supports the rehabilitation of an injured extremity through normal biomechanics. More importantly, the exercise should safely benefit the patient's rehabilitation from the passive range of motion stage through the achievement of active independent ranges of motion by the injured upper extremity.